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Briefing Papers On the Important Issues of the Day

Tobacco's dangers are well documented. However, smoking among teens is at a 16-year high. And every day, nearly 3,000 more young people across America become regular smokers. Given that nearly 80 percent of adult smokers started smoking before age 18, preventing teens from picking up the habit becomes critical.

Unfortunately, this issue is far more complex where teens are concerned. Teens who described themselves as regular cigarette smokers are three times more likely to use alcohol, eight times more likely to smoke marijuana, and 22 times more likely to use cocaine than their nonsmoking counterparts, according to a surgeon general's report. Tobacco use during adolescence is also associated with other risky behaviors, including fighting, carrying weapons and high-risk sexual behavior.

Some school-based programs have proved effective in reducing tobacco use by teens by 25 percent to 60 percent. The effects can continue for one to four years, and are enhanced by community-wide programs. According to the Centers for Disease Control and Prevention (CDC), school-based programs are most effective if they:

• Prohibit tobacco use at all school facilities and events;
• Encourage and help students and staff to quit using tobacco;
• Provide age appropriate instruction that addresses the social and psychological causes of tobacco use;
• Are part of a coordinated school health program; and
• Are reinforced by community-wide efforts to prevent tobacco use and addiction.

Through their Research to Classroom project, the CDC has identified Life Skills Training and Project Toward No Tobacco Use (Project TNT) as programs that work. The Life Skills Training assumes there are many ways to get hooked on tobacco, alcohol and drugs. Over the three-year curriculum targeted to middle school students, Life Skills Training focuses on several social risk factors such as media influence and peer pressure, as well as personal risk factors like anxiety and low self-esteem. Project TNT also uses a comprehensive approach that is well suited to a wide variety of youths. It is designed to counteract different causes of tobacco use simultaneously because the behavior can have different causes.

State Actions

Incorporating several of the CDC's recommendations into a comprehensive effort, Florida's Tobacco Pilot Program has achieved statistically significant reductions in adolescent smoking, smokeless tobacco use and cigar smoking after less than one year of operation. The program is focussed on preventing and reducing youth tobacco use. Life Skills Training, Project TNT and an elementary program are used.

Florida, Indiana, Michigan, Nebraska and Vermont require schools to have tobacco use prevention as part of their health education curriculum. Nebraska enforces its statute by penalizing school districts that do not comply. The Florida Tobacco Pilot Program now requires the health department to evaluate antismoking programs in elementary schools, and expand the program to middle and high school students. Rhode Island is now asking athletic directors to inform student athletes at the beginning of each season of the dangers of chewing tobacco.

At least 27 states have statutes that prohibit the use or possession of tobacco on or near school property. Fifteen of those states prohibit tobacco use by anyone, including the students for whom it is illegal anyway. In addition to prohibiting tobacco on school campuses, Arkansas now requires that a copy of the law be posted in conspicuous places at every entrance to the school and on school buses. Funding is always an issue for school-based programs. Arizona's Health Education Account uses tobacco taxes. Connecticut has earmarked $200,000 of the department of health budget for tobacco education for each of the next two years.

Several states enacted laws in the 1999 session to fund their school-based prevention programs with money from the tobacco settlement. New Jersey appropriated $2.2 million from the Tobacco Settlement Fund for school-based programs. The Massachusetts budget bill earmarks nearly $14 million for comprehensive health education programs including information on smoking prevention. Vermont designated money from their tobacco settlement fund to develop an early education program to promote lifelong healthy habits, which included preventing tobacco use. Wyoming established a trust fund that will pay for projects to improve the health of its citizens, including school and community prevention programs.

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"Percentage of American Youths Who Smoke Cigarettes, 1998" is not available online. Please contact the author for a copy or view the Adobe Acrobat version. Adobe Version

Selected Resources

NCSL, Health Policy Tracking Service, 1999.

Preventing Tobacco Use and Addiction: At-A-Glance, Guidelines for School Health Programs. Atlanta, Ga.: Centers for Disease Control and Prevention, June 1997.

Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Atlanta, Ga.: Centers for Disease Control and Prevention, 1994.

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